Provider Demographics
NPI:1083835243
Name:PEDRO LUGO
Entity Type:Organization
Organization Name:PEDRO LUGO
Other - Org Name:LUGO AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-826-2525
Mailing Address - Street 1:RR 3 BUZON 10807
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610
Mailing Address - Country:US
Mailing Address - Phone:787-826-2525
Mailing Address - Fax:787-818-0429
Practice Address - Street 1:CARR 109, KM. 5.3
Practice Address - Street 2:BO ESPINO
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-2525
Practice Address - Fax:787-818-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 4243416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR50740OtherPMC
PR69277OtherAMERICAN HEALTH MEDICARE
PR69277OtherAMERICAN HEALTH MEDICARE